Herb & supplement monograph

Sage Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS ·Updated July 2026

What is this page for?

First and foremost: how Sage interacts with medications. The heart of this page is the interaction list — every drug Sage is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Sage is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Sage Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Sage drug interaction appears low for most people. None of the listed interactions are rated major, and nearly all rest on lab or animal findings rather than effects seen in people.

Interactions deserving the most attention

The best-supported concern involves diabetes medications, since sage has lowered blood sugar in some human studies, though other studies in people with type 2 diabetes found no meaningful change. Blood pressure medications also deserve a mention, because one type of sage raised blood pressure in some people with hypertension while animal research points the other way. For anyone taking seizure medications, it is worth knowing that large amounts of some sage species have caused convulsions, so keeping intake modest is sensible.

What the rest of the list means

The long list of interacting medications comes mostly from lab studies suggesting sage might affect enzymes and transporters the body uses to clear many drugs. These effects are theoretical, and none of them have been reported to cause problems in people so far. A long list, in this case, reflects broad possibility rather than proven harm.

Check your medications against Sage

Based on HelloPharmacist’s Sage interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Sage

1297 medications have a known interaction with Sage, graded by severity. Select any drug for the full evidence-based detail.

Don’t want to scroll the list? Just ask.

Tell us the medications you take and we’ll check each one against Sage using our pharmacist-reviewed interaction data.

AI summaries are generated from our Sage interaction data for education only — always confirm with your pharmacist. How we use AI

2,830 drugs

Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
Probable. Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
Possible. Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
Each drug listed above links to the full report for that exact Sage combination — clinical detail, likelihood, evidence level, and citations.
Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

The big picture

The kinds of drugs Sage affects

Every type of medication (drug category) Sage is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 14 drug categories Sage interacts with

Anticholinergic DrugsAnticonvulsantsAntidiabetes DrugsAntihypertensive DrugsBenzodiazepinesCholinergic DrugsCns DepressantsCytochrome P450 2c19 (cyp2c19) SubstratesCytochrome P450 2c9 (cyp2c9) SubstratesCytochrome P450 2d6 (cyp2d6) SubstratesCytochrome P450 2e1 (cyp2e1) SubstratesCytochrome P450 3a4 (cyp3a4) SubstratesEstrogensP-glycoprotein Substrates

Anticholinergic Drugs

Theoretically, sage might decrease the clinical effects of anticholinergic drugs.
In vitro evidence suggests that common sage (Salvia officinalis) and Spanish sage (Salvia lavandulaefolia) can inhibit acetylcholinesterase and might increase acetylcholine levels.

Likelihood Possible Evidence D

Anticonvulsants

Theoretically, sage might interfere with the clinical effects of anticonvulsant drugs.
Some species of sage can cause convulsions when consumed in large quantities.

Likelihood Possible Evidence D

Antidiabetes Drugs

Theoretically, taking sage with antidiabetes drugs might increase the risk of hypoglycemia.
In patients with polycystic ovary syndrome (PCOS) or inadequately controlled type 2 diabetes, common sage (Salvia officinalis) has demonstrated hypoglycemic activity. However, other clinical research in patients with inadequately controlled type 2 diabetes shows that common sage extract does not lower fasting blood glucose levels.

Likelihood Possible Evidence B

Antihypertensive Drugs

Theoretically, sage might increase or decrease the effects of antihypertensive drugs.
Animal research suggests that common sage (Salvia officinalis) can cause prolonged blood pressure reduction. However, clinical research suggests that Spanish sage (Salvia lavandulaefolia) can increase blood pressure in some people with hypertension. Until more is known, use with caution.

Likelihood Possible Evidence D

Benzodiazepines

Theoretically, taking sage might increase the sedative and adverse effects of benzodiazepines.
In vitro evidence suggests that certain components of common sage (Salvia officinalis) can bind to benzodiazepine receptors. This effect has not been reported in humans.

Likelihood Possible Evidence D

Cholinergic Drugs

Theoretically, sage might have additive effects when used with cholinergic drugs.
In vitro evidence suggests that common sage (Salvia officinalis) and Spanish sage (Salvia lavandulaefolia) can inhibit acetylcholinesterase and might increase acetylcholine levels.

Likelihood Possible Evidence D

Cns Depressants

Theoretically, taking sage might increase the sedative and adverse effects of CNS depressants.
Some constituents of sage have CNS depressant activity.

Likelihood Possible Evidence D

Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2C19.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP2C19. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D

Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2C9.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP2C9. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D

Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2D6.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP2D6. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D

Cytochrome P450 2E1 (Cyp2E1) Substrates

Theoretically, sage might decrease the levels and clinical effects of drugs metabolized by CYP2E1.
Animal research suggests that drinking common sage (Salvia officinalis) tea increases the expression of CYP2E1. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D

Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP3A4.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP3A4. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D

Estrogens

Theoretically, sage might interfere with hormone therapy.
In vitro evidence suggests that geraniol, a constituent of Spanish sage (Salvia lavandulaefolia), exerts estrogenic activity. The clinical significance of this effect is unclear.

Likelihood Possible Evidence D

P-Glycoprotein Substrates

Theoretically, sage might increase levels of drugs transported by P-glycoprotein.
In vitro research suggests that common sage (Salvia officinalis) can inhibit the multi-drug transporter protein, P-glycoprotein. This effect has not been reported in humans.

Likelihood Possible Evidence D

Monograph

Sage: Uses, Safety & Side Effects

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Reviewed July 2026 ·

The bottom line

Sage is a common kitchen herb that is generally safe in food amounts and is traditionally used for sore throats, digestion, sweating, and memory. Some early research is encouraging for sore throat and menopausal hot flashes, but most uses are not well proven. Concentrated extracts and the essential oil should be used carefully because high doses contain a compound called thujone, which can be harmful.

Scientific name: Salvia officinalis
Family: Lamiaceae
Part used: Leaves and essential oil
Common forms: Tea, capsules, tablets, tincture/extract, essential oil, lozenges, mouth rinse/gargle

People commonly use it for

Sore throat and mouth irritation
Digestive upset
Excessive sweating
Memory and thinking
Menopause symptoms (hot flashes)
General antioxidant support

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance

OverallUse caution

Generally safe as a food and short-term as tea, but concentrated extracts and the essential oil should be used cautiously.

PregnancyLikely Unsafe

When used orally. The constituent thujone can have menstrual stimulant and abortifacient effects.

Read the full pregnancy detail

BreastfeedingPossibly Unsafe

When used orally; sage is thought to reduce the supply of mother's milk.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

Sage (Salvia officinalis) is a fragrant, perennial herb in the mint family (Lamiaceae). It is native to the Mediterranean region but is now grown around the world for cooking and for use as a remedy.

The soft, gray-green leaves are the part most often used. They can be used fresh or dried to make tea, swallowed as capsules or tablets, taken as a liquid extract, or distilled into an essential oil. Sage has a long history in traditional medicine for sore throats, digestion, sweating, and as a tonic for the mind.

How it works

Sage contains many natural compounds, including rosmarinic acid, flavonoids, and aromatic oils such as thujone, camphor, and cineole. These give sage its antioxidant, anti-inflammatory, and antimicrobial activity in laboratory tests.

Researchers think some sage compounds may affect chemicals in the brain involved in memory, which is one reason it has been studied for thinking and mood. Other compounds may relax tissue, fight germs, or affect blood sugar.

It is important to know that much of this information comes from laboratory and animal research. What happens in a test tube does not always happen in the human body, so these mechanisms do not prove sage works for any specific condition.

Effectiveness

Does Sage work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by Dr. Brian Staiger, PharmD.

Evidence overview · 23 uses evaluated

3 Possibly effective 1 Leans ineffective 19 Insufficient evidence

How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.

2Likely EffectiveGood evidence, though not yet conclusive.

3Possibly EffectiveSome evidence suggests a benefit.

4Possibly IneffectiveSome evidence it may not help.

5Likely IneffectiveFairly strong evidence it doesn’t help.

6IneffectiveStrong evidence it doesn’t work.

7Insufficient Reliable Evidence to RateToo little research to say either way.

Possibly Effective Cognitive function